Against appearances, cosmetic surgery is not a 20th century phenomenon . Descriptions of nasal corrections and scar treatments dating back to Ancient Egypt are preserved, and as early as the 7th century, the Alexandrian physician Pablo de Aegina developed a system to remove men’s breasts, an aesthetic issue defined by treatises of the time such as medical problem. Nor is liposuction new, for Pliny the Elder, in the first century after Christ, describes a “heroic cure for obesity” to the son of a consul.
With a few exceptions, all plastic surgery patients up to the 19th century were men. In fact, the true engine of cosmetic surgery came in the Renaissance with the appearance of epidemic syphilis, a venereal disease imported from the American continent. The mission of the new decorative chirugia was to rebuild the syphilitic nose, which was eaten away or disappeared due to the effects of the disease.
Year 1597: In his rhinoplasty operation he used the graft of a tissue flap that we have between the biceps. The operation required that the flap, not yet separated from the arm, remained attached to the stump of the nose of the emaciated patient for a period of 20 days using a strong sling (right). After a month of work, excruciating pain and more than likely infections, a rudimentary nose appeared (left).
The operation never stopped being performed, but the Catholic Church did not quite like the idea of doctors surgically rectifying the scars and deformities caused by a disease such as syphilis . The Vatican condemned ‘decorative surgery’ and Tagliacozzi’s lessons were ‘forgotten’ because they were human interference in the realm of divine punishment.
The enlightened philosophy of the nineteenth century, with the new notion of the individual who could remake himself to find happiness, laid the foundation for the modern culture of cosmetic surgery. The impetus came with the introduction in 1846 of anesthesia and, later, of antisepsis in 1867. The reduction of pain and infections, together with the enlightened mindset, increased the possibilities of operating on patients of their own free will, and not because of real need.
Jakob Joseph was a young Jewish surgeon who at the end of the 19th century changed his name to Jacques Joseph to disguise his origin. Joseph began operating in Berlin ‘Jewish ears’ (bat type) to relieve complexes and developed a method that modified the typical Semitic nose. By Germanizing the face, his fellow men could go unnoticed in the early days of the anti-Semitic political movement.
The first ‘belly remover’ operation took place in Baltimore in 1899, and seven kilos of fat were removed from the abdomen of a 32-year-old Jewish woman weighing 120; the first facelift came in 1901; the first surgical intervention of the eyelids was in 1906; Subcutaneous fat injections began in the 1920s as a way to smooth the skin of an aging face without the need for stretching.
After World War I, surgery went from disguising ethnic traits and aging to sexual transformation. Dr. Richard Mühsam, from the Berlin municipal hospital, explained that in 1920 a patient came to him to have him castrated, expressing his desire to become a woman. The boy had an ovary implanted to generate female hormones, and as a result he developed breasts and his voice became effeminate. Mühsam did not dare to amputate his penis and created a simulated vagina in which he placed his member so that it could be sexually stimulated.